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St. Michael’s participated in drafting new Canadian Diabetes Association guidelines

Toronto, April 9, 2013

By Leslie Shepherd

Clinical Practice Guidelines
Clinical Practice Guidelines.

Seventeen health care providers and researchers from St. Michael’s Hospital were involved in drafting the new Canadian Diabetes Association guidelines for preventing, diagnosing and treating diabetes, including Dr. Alice Cheng, who chaired the guidelines committee.

The national Clinical Practice Guidelines are intended to help health care professionals determine how best to manage and treat diabetes and reduce the potential for serious complications such as heart, kidney and eye disease. New interactive web-based tools released with the guidelines are also intended to give patients a bigger role in managing their disease.

“Updated every five years, the 2013 Canadian Diabetes Association clinical practice guidelines represent the efforts of 120 national diabetes experts from 19 different disciplines who volunteered their time and effort for the past three years,” said Dr. Cheng, an endocrinologist at St. Michael’s.

“These guidelines continue the tradition of quality evidence-based recommendations which will inform and support the care of people with diabetes. Many members of the expert committee hail from St. Michael's Hospital, again supporting the mission of the hospital to be a leader in diabetes prevention and treatment.”

The new guidelines recommend:

  • Everyone over 40 should be screened for Type 2 diabetes every three years – and more frequently for people with risk factors for the disease.
  • The A1C test, which measures average blood glucose levels, can be used for screening. The test, which can be done at any time, eliminates the need for fasting in advance.
  • People with a blood glucose level of 6.5 per cent of higher will be considered to be diabetic and those with a level of 6.0-6.4 per cent will be diagnosed with pre-diabetes. A normal glucose level is considered to be less than 5.7 per cent.
  • People with diabetes who are over 40 should automatically be put on cholesterol-lowering drugs; those 55 and older should be put on heart-protecting medication.

In addition to Dr. Cheng, the St. Michael’s health care providers who participated in the development were:

Dr. Gillian Booth, an endocrinologist (methods chair)
Dr. David Fitchett, a cardiologist (steering committee member)
Dr. Amir Hanna, an endocrinologist (steering committee member)
Dr. Onil Bhattacharrya, a family physician (steering committee member)
Dr. Fil Alomare, an ophthalmologist,( chapter author)
Dr. Shelley Boyd, an ophthalmologist (chapter author)
Dr. Howard Berger, a perinatologist (chapter author)
Dr. Richard Gilbert, an endocrinologist (chapter author)
Dr. Jeannette Goguen, an endocrinologist (chapter author)
Dr. Andrew Advani, an endocrinologist (chapter author)
Dr. Phil McFarlane, a nephrologist (chapter author)
Sandi Williams, a dietician (chapter author)
Dana Whitham, a professional practice leader (chapter author)
Dr. Catherine Yu, an endocrinologist (chair of the dissemination committee)
Dr. John Sievenpiper, a researcher at the hospital’s Clinical Nutrition and Risk Factor Modification Centre (chapter co-author)

Dr. Lawrence Leiter, an endocrinologist and steering committee member has been involved in every guideline review since 1992.

“The involvement of so many St. Michael’s individuals in the guidelines process is a testament to the hospital’s investment in evidence-based care and expertise in knowledge synthesis and knowledge translation,” said Dr. Yu.

“For example, the Division of Endocrinology has been actively involved in the guidelines since their original inception, and over the course of the years, has continued to nurture and support young faculty into developing key leadership roles in the guidelines process."